Tainted Saints

Since Joe Lieberman demanded stripping the public option and Medicare buy-in provisions from the merged Senate bill, some strong progressives like Howard Dean have argued that without a public option or a Medicare buy-in provision, the bill is a giveaway to private insurers and should be killed. Other progressive leaders like Senators Jay Rockefeller, Tom Harkin and Sherrod Brown believe that the bill represents the best chance for passing health care reform in the foreseeable future. “I’m going to vote for it,” Brown told reporters. “I can’t imagine I wouldn’t. I mean there’s too much at stake.”

Change of the magnitude envisioned by health care reformers does not come easily. There have been many frustrations and there will be more. But, as a senior White House staffer with a ringside seat for the slow death of comprehensive care in 1994, I am keenly aware of the real alternative to the bills now before us: millions more Americans without health care and billions more for health care spending as the same challenges President Clinton tried to resolve continue to metastasize unchecked.

So while I have great respect for Governor Dean, and we have worked together to provide the strongest health care reform bill for the American people, I come down on the side of the Senate passing the bill.

Here’s why:

The Senate health care bill is not without its problems. But if enacted, it would represent the most significant public reform of our health care system that Congress has passed in the 40 plus years I have worked in politics. The bill will give health care coverage to a record 31 million Americans who are currently uninsured, lay a foundation that will begin to lower costs for millions of families, and provide all Americans with the access to adequate and dependable coverage when they need it most.

[The top ten reasons for why progressives should support the Senate passing the bill...]

Dr. Howard Dean has a prescription for health-care reform:

Scrap the ridiculously compromised Senate bill — from which Majority Leader Harry Reid has, under pressure from Connecticut Senator Joe Lieberman, stripped both the public option and plans to expand Medicare — and use the budget reconciliation process to get over the 60-vote hurdle in the Senate.

“This is essentially the collapse of health care reform in the United States Senate,” the former Vermont governor, presidential candidate and Democratic National Committee chairman said of Reid’s compromise. “Honestly the best thing to do right now is kill the Senate bill, go back to the House, start the reconciliation process, where you only need 51 votes and it would be a much simpler bill.”

The budget reconciliation process, which was established in its current form by Republicans when they controlled the Senate, allows a omnibus legislation to be broken up and passed in new bills that pertain to budgetary matters.

It is complicated and imperfect, as it would require the passage of insurance regulations in a separate process with different rules.

Is this going to happen?

Probably not, as Senate Democrats would have to break not just with Reid but with President Obama, who is pressing for passage a bill, no matter how watered down it may be. [more...]

The first rule of medicine is, “Do no harm.” The post-Joe Lieberman version of the Senate health care bill fails that basic criterion. Unless Democratic leadership steps up to fix this misguided proposal, our only recourse will be to kill it.

The fundamental failing of the newest Senate proposal is that it requires individuals to purchase health insurance, but does nothing to rein in what insurance companies charge. There is nothing to stop spiraling health costs from eating up an ever-increasing percentage of our national productivity.

The House bill has two major cost-control mechanisms: the public option and the 85 percent medical-loss ratio requirement. The Senate bill is on track to have neither, and nothing new to replace them. The Senate bill is a recipe for national disaster. If it’s that bill or nothing, I prefer nothing.

We all know America’s current health care system is failing — and it’s failing everyone, not just the uninsured. It is far too expensive: Americans spend 16 percent  of GDP on health care and get worse results than countries that spend half that. Literally.

We need health reform that expands access to quality health care, abolishes unjust practices of insurers, improves value to the country, and puts us on a trajectory to continue to improve our health care system over time.

But the Senate has systematically stripped out nearly everything I liked about what was proposed in the early, heady days of health care reform. They have done so in order to please a handful of so-called centrists who care more about protecting corporate profits than protecting the people they claim to represent. [more...]

The Senate narrowly rejected an amendment that would have restricted abortion coverage in the pending health-care bill, leaving in question whether Majority Leader Harry Reid (Nev.) has the 60 votes needed to move the bill toward final passage.

The measure, which failed 54-45, addressed the scope of restrictions on coverage of abortion services for people who receive subsidies to buy insurance. The outcome was expected, but could cost the support of Sen. Ben Nelson (D-Neb.), who has threatened to filibuster the $848 billion bill unless abortion restrictions are tightened.

Reid told reporters earlier Tuesday afternoon he would consider other language to allay Nelson’s concerns. “If in fact he doesn’t succeed here, we’ll try something else,” Reid said. [more...]

The Democrats downplaying the gravity of new recommendations for breast cancer screening have left out an inconvenient fact: their health care bills would automatically adopt them.

Both the House and Senate health reform proposals would force insurance plans to follow the new mammogram guidelines for women ages 50 to 74 as part of a minimum swath of services deemed by the legislation to be medically essential. The recommendations were an unexpected wildcard in the middle of an already contentious health reform debate, and they’ve caused Democrats to de-emphasize their significance at the same time that some in the party are calling for a legislative fix to nullify them.

The animated reaction to the recommendations follows several weeks in which women’s reproductive health had been at the forefront of the health reform debate, after the House passed a provision limiting coverage of abortion under private plans. The saga has been a distraction to Democrats as they aim to enact the most sweeping health care reform in generations, and it’s complicated their defense against GOP-fueled charges that their proposals would lead to a rationing of care. House leaders have already passed their version of the bill, but the debate in the Senate is just beginning, with upper-chamber leaders scheduled to vote Saturday on a procedural measure to bring their bill to the floor.

The mammogram episode has also revealed the influence of a previously obscure preventive-medicine panel, raised questions about the effectiveness of the Democrats’ reform proposals to weed out unnecessary medical procedures, and highlighted the potential complications when the entrenched habits of patients and providers are called into question by medical science. [more...]

WASHINGTON (Reuters) – President Barack Obama’s U.S. healthcare overhaul plan has cleared an important Senate hurdle but lawmakers warned on Sunday of challenges ahead in winning support for passage, even among Obama’s own Democrats.

On Saturday, Senate Democrats gathered the 60 votes needed to open floor debate on the plan, which would make the biggest changes in the $2.5 trillion healthcare system in 40 years. It is the Obama administration’s top domestic policy initiative.

No Republicans backed the procedural motion and a handful of conservative Democrats, whose votes were crucial, supported the floor debate but remained uncommitted to the bill itself.

One of those was Democratic Senator Ben Nelson, who said on Sunday that he could not support the plan without big changes. [more...]

It can now be safely sated that the Senate will not pass the Stupak amendment.

Because 60 votes are required to attach an amendment to a bill in the Senate, there is no chance that the Senate will include the Stupak amendment in the health care bill it sends to conference committee.  And, there simply are not 60 votes in favor the amendment in the Senate:

Senator Barbara Boxer (D-Calif.) said that 60 votes would be needed to strip the current health care bill of its abortion-related language and replace it with a version resembling that passed by the House of Representatives on Saturday. And, in an interview with the Huffington Post, the California Democrat predicted that pro-choice forces in the Senate would keep that from happening.

“If someone wants to offer this very radical amendment, which would really tear apart [a decades-long] compromise, then I think at that point they would need to have 60 votes to do it,” Boxer said. “And I believe in our Senate we can hold it.”

“It is a much more pro-choice Senate than it has been in a long time,” she added. “And it is much more pro-choice than the House.” [more...]